BORN WITH PAIN BUILT IN
PCOS Pains in the Philippine Context
by Lian Gabrielle Inlong
“Nag-iinarte lang ‘yan,” says my high school science teacher about girls who are unable to go to class due to dysmenorrhea. For him, period pains are normal as women have significantly higher pain tolerance than men. At 16, I believed him even as I dealt with severe cramps that would have me curled up and crying in bed once my period returned after months of absence. It took me four years and numerous doctors to learn this was not normal as polycystic ovary syndrome (PCOS) was an actual health concern that women silently face.
“Nag-iinarte” haunts me still when I tell people that I am diagnosed with PCOS after unsolicited comments like “tumaba ka,” and “ang dami mong pimples,” are dropped in social gatherings. They would then tell us, “Wala namang ganyan no’ng araw,” which is infuriating because it invalidates pain forcing women and even little girls to prove themselves, even when it comes to their own health. A lot of women have to go through this exact experience because most people remain oblivious to what PCOS is.
Young women are conditioned to think that pain is normal when going through changes, always undermining their own experiences and never addressing them. Usually, these experiences are dismissed as “being overdramatic.” But PCOS is real — women afflicted with PCOS suffer through irregular periods, acne, uncontrolled weight gain, and excessive hair growth especially on the face. Others complain of excruciating pains, typically migraines and cramps, during their periods. They also deal with mental health concerns because of the hormonal imbalance that affects how they regulate their emotions.
Women are diagnosed with PCOS when they show at least two of the following manifestations: irregular period, hyperandrogenism, and polycystic ovaries. Moreover, PCOS patients are prone to type-2 diabetes as insulin-resistance is a factor to the still unknown cause of PCOS. Women affected with PCOS also have a higher chance of experiencing infertility and miscarriages.
Unfortunately, there is still no treatment for PCOS and doctors often only prescribe ways to manage the syndrome. In the Philippines, a common management prescription is combined oral contraceptive pills that help in regulating cycles and reducing androgen levels. For critical cases, an ovariectomy or the surgical removal of the ovary is recommended.
Before my diagnosis, I have met plenty of doctors with varying opinions on the syndrome. The worst was a male doctor vilifying women’s modern lifestyles, such as poor diet and sedentary lifestyles, for bringing about rapid weight gain and irregular periods in PCOS. Other encounters succeeded this as other doctors have questioned the increase in numbers of PCOS patients today. I had a hard time getting diagnosed as a patient in the obstetrics and gynecology department which, in the Philippines, was not a place for the unmarried — let alone a minor. Some tests, which should have been the practical route to diagnose a suspected PCOS patient, were avoided just because of the taboo of virginity.
As a woman, it is frustrating to be invalidated and be told that you are imagining the pain when you know and feel, physically and emotionally, that there is something wrong with your own body. For many women, not just in the Philippines but all over the world, the frustration over the lack of awareness on PCOS is often left unresolved.
The PCOS community on Tiktok is one safe space that allows women to share their journey in battling the syndrome. Multiple women shared the same frustration over shifting between different doctors before being diagnosed as many professionals would dismiss symptoms as plain stress and fatigue. Filipinos in the community opened up about how demeaning it is to have PCOS in Filipino households due to people always pointing out side effects that are out of their control. Through the community, women are able to spread awareness on what PCOS is, allowing for many others to get diagnosed as well. Women can help one another to manage symptoms through lifestyle and nutrition advice that has been proven and tested.
Unhealthy nuances, not only on PCOS but also on other reproductive health concerns, make it difficult for a lot of women to address their health issues. If it took long for a privileged, sixteen-year-old like me to have access to primary health care, imagine how prolonged it was for underprivileged women. To note, over 70% of women worldwide remain undiagnosed for PCOS when it significantly affects 8–13% of women of reproductive age.
Relatedly, College of Human Ecology of the University of the Philippines Los Banos conducted a study where they shared that 4.5 million women in the Philippines are living with PCOS. The enormity of cases shows the alarming reality that PCOS is a real thing many women suffer through. The continuous dismissal of PCOS as mere stress and fatigue and as a syndrome that used to be “non-existent” perpetuates a society that disregards the welfare of women. These numbers serve as a reminder to put reproductive health on top of the list of priorities that we as a society should be focusing on.
Treating reproductive health and sex as taboo jeopardizes the health of people, not just women. Women with reproductive health issues are afraid to speak up because society cultivated a culture to persecute women who are in touch with their sex lives — reproductive health included. They are often left to endure because when they do speak up, they are dismissed with their pain underestimated.
Many might argue that studies have already been conducted before and treatment and management are being given to patients; however, studies would not suffice when the affected, underprivileged individuals are challenged by scarce information and access to proper health care. More importantly, the refusal to use one’s privilege and social responsibility to openly discuss health information puts the affected sectors of society at a greater danger.
Reproductive health should be as talked about as often as other illnesses. It should not be left hidden in our backrooms just because people shame others for bringing it up.
“Women are born with pain built in,” as Belinda from Fleabag said. But this does not mean that we have to endure this pain and leave it unaddressed. As women, we have been deprived of so many things, but the right to diminish our burdens should not be one of them.
